| NPI | 1124096375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N0504) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11550) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2017-03-13 |